25D0993038 CLIA NUMBER - SOUTH CENTRAL CARDIAC CLINIC

Laboratory Demographics

  • CLIA Code: 25D0993038
  • Facility Name: SOUTH CENTRAL CARDIAC CLINIC
  • Facility Address: 311 SOUTH 12TH ST
    LAUREL, MS
    ZIP 39440
  • Facility Phone: 601 649-2863
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM D. SULLIVAN
  • NPI Number: 1821515388
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0993038
LAB Type Physician Office
Facility Name SOUTH CENTRAL CARDIAC CLINIC
Street 311 SOUTH 12TH ST
City LAUREL
State MS
ZIP 39440
Phone 601 649-2863
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Physician Office
Lab Director WILLIAM D. SULLIVAN

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This page was last updated on: 9/29/2025